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DAVID GREENE, host: This is WEEKENDS on ALL THINGS CONSIDERED from NPR News. I'm David Greene, in for Guy Raz.

For many of us, this is the sound of the season.

(SOUNDBITE OF MUSIC)

GREENE: Football is back. The NFL lockout is history. Teams at all levels are deep into practice. But there's a cloud hanging over this season. Never before have the devastating effects of concussions been so clear. In the NFL last year, the toll was obvious.

(SOUNDBITE OF NFL GAME)

UNIDENTIFIED MAN: Oh.

Oh.

Man.

A hit.

Oh, (unintelligible). He gets knocked out.

Oh, (unintelligible).

He did not see that hit coming.

He hasn't moved since he took that hit.

GREENE: The off-season brought another brutal reminder. Dave Duerson, the hard-hitting former Chicago Bear, committed suicide, and one factor cited was the brain trauma he suffered on the field.

Our cover story today: football: finding the balance between safety and playing to win. We'll start with the story of a high school star from the Upper Peninsula of Michigan.

(SOUNDBITE OF MUSIC)

SPENCER HELGREN: My name is Spencer Helgren. I'm a offensive guard and defensive tackle for the Westwood Patriots. I'm from West Ishpeming, and I'm 17 years old.

GREENE: Spencer's a senior now. In the third quarter of a game late last season, he took a head-to-head hit.

HELGREN: I didn't think anything of it. Just normal got my bell rung. It happens.

GREENE: A few plays later, a blocker knocked him over.

HELGREN: And I fell on the ground, and I hit my elbow, and I hurt. And I started crying. No, I'm not the kind of person that cries, ever. I mean, I'm, you know, I'm usually that guy that's kind of like a wall that, you know, you'd never be able to tell if I'm hurt or anything. Just fight through the pain, you know? You've got a job to do and you do it. But I started bawling my eyes out.

GREENE: The trainer gave him a few simple tests.

HELGREN: I looked to be fine except for the fact that I was an emotional roller coaster. I wasn't fine at all.

GREENE: And this is what medical professionals are trying to teach coaches. There are so many different signs of a concussion injury, and they need to know all of them.

Jamey DuBose coaches the Prattville High Lions in Alabama. They are ranked number one in the nation this season by Rivals.com. Coach DuBose says he's changed the way he handles his players.

JAMEY DUBOSE: If it's a head injury, we don't risk. We don't go any further. It's a shutdown method, and that's what we've been told as far as the high school athletic association and all the doctors that have educated us on it.

GREENE: Well, you said you're going to be potentially going overboard. I guess I'm wondering, how often do you think you'll be making decisions about a player, you know, how many times in a game or how many times in a season that you wouldn't have made, you know, two, four, 10 years ago?

DUBOSE: Well, I know we had a scrimmage Friday night. This just come in recently, and we had a kid to take a very big shot on the sideline on a kick return, kind of got blindsided a little bit with a legal hit, but he was scrambled a little bit. And we went ahead and shut him down. And I'm thinking, you know, if I would've been just a coach 10, 15 years ago, that player probably would've been back out there playing again.

GREENE: And, coach, I guess there just seems to be this real fundamental tension here as we talk about this between, you know, safety and then this, you know, the old school football tradition. You get hit, you get up, and you go out, and you hit back harder. How do you find the right balance?

DUBOSE: I can remember the days of somebody laying on the ground and that showed that you wasn't a very tough person, if you wasn't laying on the ground. I'll be honest with you, I was at that youth clinic yesterday and a kid was complaining, a little kid, out of first grade maybe or something. I was standing over on the side, and he went over to get some water from his mom during a drill, and I heard the mom - the mother, of all people - say, you got to suck it up and get back out there.

GREENE: Ooh.

DUBOSE: Well, you know, I mean, that mentality sometimes needs to be changed, I guess, is, you know, the kids are told maybe at home that, you know, you better - you're not hurt. I remember when I played. I got a concussion one time and came to the sideline and my dad was like, oh, he's all right. Get him back out there. Get him back out there. But we didn't know till later I had a concussion.

And I think the old school of thumb is, you know, if you are - a sign of weakness, so to speak, if you're on the sideline, but we're trying to educate them that it's not a sign of weakness. It's just a sign of let's make sure you're taken care of to get back out there as quick as you can.

GREENE: Jamey DuBose is head coach of the Prattville Lions in Prattville, Alabama. Thanks for joining us, and have a good season.

DUBOSE: Thank you.

GREENE: Now, back in Michigan, Spencer Helgren's coaches were adamant that after his concussion, he couldn't play until he got medical clearance. He did, the day before the next game, the season finale. Since he missed most of the week's practice, he wasn't allowed to start.

HELGREN: I was a little, I don't know, angry just because, well, three years I've been starting both waves. I hadn't missed a game. And then here we are now. I got a little bump on the head and I have to sit out.

GREENE: Then late in the third quarter, Spencer went into the game. And as usual, he tangled with a big offensive lineman and he got hit.

HELGREN: It was head on head contact with another player, which the guy across from me had to have been at least 300 pounds. You know, he was a big fellow. I was kind of zigzagging over to the sideline.

GREENE: Spencer sat down on the bench. The team's trainer delivered the news: He was out of the game.

HELGREN: That's what started the six-month, 24-hour a day splitting headache that never went away. I started getting really sensitive to light. I couldn't concentrate or focus. I'm trying to do school, because this was during school. And, you know, I'm a straight A student, you know, my whole life. When I started, you know, really hitting on the books again, I just - I couldn't look - I couldn't read, you know, a book anymore. I enjoyed reading. I couldn't look at a book and read from top to bottom and remember what I read in the middle.

GREENE: Chris Nowinski understands these symptoms firsthand. He suffered six concussions as a college player and then a professional WWE wrestler. Now he's co-director of a brain research center at Boston University focusing on a disease that's known as CTE.

CHRIS NOWINSKI: There was a study that came out out of the University of Illinois that put censors in helmets of high school players for a few years. The average high school player took over 800 blows to the head at the minimum threshold of 15 G's, which is not a small hit. There was one poor kid who took 2,235 hits to the head in one season.

GREENE: In one high school season?

NOWINSKI: One high school season. When you step back, and now that we're finally starting to quantify this, you cannot find an activity that people are voluntarily letting children participate in that exposes them to over 2,000 hits to the head in a short period of time. And the reality is when you find CTE in 18-year-old kids - in Owen Thomas, the 21-year-old co-captain of the Penn football team that committed suicide last year - when you're finding it in guys that are supposed to be fine and they've played fine and they've played all the fundamentals right, clearly, the fundamentals and everything that, you know, every habit that we've had has been the problem.

GREENE: How do coaches change the fundamentals without changing the sport of football?

NOWINSKI: If you look at, say, a kid who's taking 2,000 hits to the head, the day that will say that 1,200 of those hits come in practice. Well, practice nobody's keeping score and nobody cares. And so the reality is you could virtually eliminate almost all of those 1,200 hits just by reinventing how we practice the game of football to not involve collisions. We've been working with a number of youth football programs through Sports Legacy that have virtually eliminated hitting from practice and discovered miraculously that they can still win games and they still are playing just as well.

GREENE: What is your guidance to sort of the sport and people who love it this year? I mean, can they be excited? Are these new dangerous times? Based on everything you've learned, what would you say?

NOWINSKI: I think you can still be excited about football, and there's still a number of aspects about football that are magical and terrific to get fired up about that don't involve the risk of people having lifetime trauma.

GREENE: You know these symptoms firsthand. You suffered, I think, six concussions of your own, is that right?

NOWINSKI: Well, six concussions in my 20s. I have no idea how I suffered as a child.

GREENE: Do you ever think about sort of what might develop 10, 20, 30 years from now, I mean, if you might have CTE from your concussions and sort of what your future might hold?

NOWINSKI: Well, the reality is I certainly think there's a very strong risk I have it already progressing in my brain. I'm actually one of our guinea pigs for a lot of our advanced imaging studies and things to try to find a diagnostic. And the best news I got in a small pilot study of five of us on some imaging is I was the least abnormal. But the reality is also that, you know, CTE is not, you know, I look on the bright side that there have been guys in our brain bank who've had CTE who also lived very normal lives. So I think, you know, if it is occurring in my brain, it's just something I have to deal with, and it keeps me motivated to go find that treatment that we all need.

GREENE: That's Chris Nowinski. He's co-founder and president of the Sports Legacy Institute. And he spoke to us from member station WBUR in Boston. Chris, thanks for being here.

NOWINSKI: Thanks for having me.

GREENE: The thing is young men like Spencer Helgren in Michigan, they grow up dreaming of football.

HELGREN: For one, you know, the love of the game. I'm not the kind of person that likes playing football because I like to hit people. OK? That's kind of like, I guess, an added bonus, you know? But I'm that kind of person where I love the game. It's - I love the teamwork. I love the effort. I love the work, you know? And it's just I love the game.

GREENE: That's why so many people are trying to find a way to make the game safer. People like researcher Stefan Duma of Virginia Tech University. Duma did a study of football helmets, and he found that the most popular helmet in the NFL last season ranked second from the bottom in terms of safety.

STEFAN DUMA: That's the VSR4, and that's kind of the historical almost a workhorse of college and professional football, if you will. A lot of teams have it. A lot of teams keep using it. A lot of the players in the NFL grew up with that helmet, and so they want to keep it.

GREENE: I do want to underline this, though. I mean, a very large number of NFL players are wearing a helmet that you've given one star to that you say basically is - really creates a risk of concussion injury.

DUMA: There's no question if you're in the VSR4 you have a significantly higher - almost double the risk of concussion than the newer, better helmets. And even here at Virginia Tech, we had this problem. Last year, about half of our team had this older VSR4, which we gave a one star. So as soon as we finalized the results, you know, I called Dr. Brolinson, Mike Goforth, and we had a very quick conversation. And we agreed that simply, we're going to get rid of all the old helmets and all of our players are going to be in the new, best five-star helmet this fall.

GREENE: We've been learning about the research into football helmets from Professor Stefan Duma at Virginia Tech University. Professor, thank you for being with us.

DUMA: Thank you. Have a good day.

GREENE: As far as Spencer Helgren up in Michigan, he's at football practice.

HELGREN: Right now, I am fully back. I am - actually, we - this is our first week (unintelligible), and I'm loving every minute of it.

GREENE: And he's not changing a thing about his game.

HELGREN: It's when you hold back and you're thinking, ooh, I might hit my head on this play is where you're going to hit your head, you know? When you started holding back in kind of fear, you can actually put yourself in danger.

GREENE: This is ALL THINGS CONSIDERED from NPR News.

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